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在初次接种狂犬病疫苗后的7-14天,几乎所有的接种者体内均可产生足够的中和抗体。研究表明灭活狂犬病疫苗可刺激B淋巴细胞和CD4+ T细胞,通过组织MHCII通路诱导机体产生保护性中和抗体,产生的抗体可以迁移到神经系统的软组织细胞来中和病毒。CD4+ T细胞的激活最终导致中和抗体的产生,而中和抗体在预防狂犬病发生中起主要作用。
狂犬病疫苗对几乎所有的人均有很好的免疫效果,对CD4+T细胞很低的病人除外。一项研究表明CD4+ T细胞在400以下的HIV感染者在肌肉注射5针狂苗后只有57%的受试者抗体水平在0.5IU/mL以上。另一项研究显示,13个HIV儿童感染者,CD4+T细胞比正常儿童低15%,他们在接种3剂暴露前免疫后,HIV感染儿童产生的中和抗体明显低于对照组正常儿童,而且其中4个没有产生抗体。对这类HIV感染者为诱导产生足够的中和抗体可以采取真皮内多点注射疫苗。另一项研究,将CD4+T细胞数量高于200和低于200的各位一组,分别在0,3,7,14和30天的时候,进行8点真皮内的暴露后免疫,最终所有参与试验的HIV感染者体内抗体均高于0.5IU/mL。
有研究显示年龄高于50岁老年人在接种狂苗后产生的抗体低于年轻人;但在一个有875人2-74岁年龄段参与的临床试验中,显示抗体应答与年龄和性别没有明显的相关性。狂犬病疫苗在儿童中有很好的免疫应答效果。人用狂犬病疫苗对孕妇也是安全有效的。
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